Question 1

A unit secretary mistakenly enters the wrong medication into the MAR when transcribing orders.After a root cause analysis, it is determined that the cause is the illegibility of the physician's order.Which measure should be taken to prevent future incidences?
A)The physician is required to carry a typewriter with him to type the orders onto the order sheet.
B)The physician must either write legibly or orders will not be transcribed.
C)The unit secretary must receive more training on transcribing orders.
D)Introduction of a computer entry system for all physician orders will be instituted.

Accepted Answer

A computer entry system eliminates most errors for all people involved.The other options do not address the root cause or prevent future errors involving other employees.

Question 2

What area is included when risk management explores the prevention of accidents, injuries, and errors?
A)Financial risk
B)Quality of care
C)Employee management
D)Employee promotion

Accepted Answer

The financial risk for injuries, errors, and accidents will always be incorporated into the decision-making process.The others are not part of the risk management program.

Question 3

When using the DMAIC acronym of the Six Sigma quality process improvement model, the nurse understands that the D (define) refers to
A)the cost of getting a new MRI machine.
B)the patients and their families.
C)the number of dollars in donations.
D)the number of dollars spent on charity.

Accepted Answer

Define means to define the customer for whom improvement is directed.The other options are not the meaning of define in DMAIC.

Question 4

A nurse is learning about quality improvement measures taken by the hospital.Root cause analysis is a process for identifying the cause of an error.What is the greatest benefit to establishing the root cause?
A)Prevention of future similar incidents
B)Identification of the responsible person
C)Allows corrective action to be taken
D)Identification of cause

Accepted Answer

The purpose of investigations of errors is to prevent incidents in the future.The options are not the greatest benefit to the process.

Question 5

"Lean culture" is a term used for the principle of eliminating waste.Which illustrates the principle that nurses must do more with less?
A)Assigning the night shift RN to restock the rooms.
B)Employing a staff member to stock all patient rooms for frequently used supplies.
C)Assigning all nurses to restock their rooms every day.
D)Placing all frequently used supplies in a central location.

Accepted Answer

Providing a staff member to restock the rooms frees up the nurses to spend time caring for their patients.The others are a possible solution but having a staff member devoted to this would allow the nurse to spend time appropriately.

Question 6

What is the best method for hospitals to track patient satisfaction?
A)Family buys chocolates for each shift.
B)Family speaks to the charge nurse about how unhappy they are with a particular employee.
C)Family writes a letter to the unit and to the chief nurse officer to thank the staff for providing care and compassion even though their family member died.
D)Patient completes a patient survey after returning home from the hospital.

Accepted Answer

Although letters and chocolates are nice, performance measures are data driven and not anecdotal.The other options do not provide data.

Question 7

A sentinel event is usually one that results in an unexpected outcome for the patient and "signals" the need for investigation and response.Which of the following would be considered a sentinel event?
A)A patient who requires a left leg amputation after developing an arterial occlusion at the access site
B)An older adult patient who falls after trying to get up by herself
C)A patient who receives two doses of amiodarone because the nurse did not chart the first one
D)A patient whose peripheral pulses have not been checked for 2 hours after he returns from a cardiac catheterization

Accepted Answer

The patient incurred unexpected results from the procedure and lost a limb.The other options do not qualify as a sentinel event.

Question 8

The National Patient Safety Goals of The Joint Commission ( TJC ) are established goals to reduce the risks for injuries to patients and provide a safe environment.Which practice has been instituted as a result of these goals established by TJC?
A)Use of the automatic medication dispenser equipment
B)Handwashing to prevent infections
C)Provision of patient information to the nurse covering for breaks
D)Use of two patient identifiers when providing care or treatments

Accepted Answer

The institution of two patient identifiers is a TJC National Patient Safety Goal.The others are not listed as a TJC goal.

Question 9

Risk management is a hospital program organized to prevent the incidences of preventable accidents, injuries, and errors.Which of the following situations would a hospital risk manager need to investigate?
A)A patient breaks his wrist from a fall caused by a wet floor.
B)A patient receives a dose of subcutaneous heparin 1 hour later than scheduled.
C)A patient who is NPO is not given her morning medications.
D)A patient who is allergic to shellfish is given preprocedure medications to reduce his risk for allergic reaction to the dye being used in the procedure.

Accepted Answer

This is a preventable accident and injury and would be reviewed by the risk management department.The other situations do not apply for review by risk management.

Question 10

The National Database of Nursing Quality Indicators (NDNQI) has established which of the following goals to assist nurses to make practice changes in order to benefit patients?
A)Patient satisfaction
B)Employee satisfaction
C)Unit-specific measures
D)Medication errors

Accepted Answer

The NDNQI tracks unit-specific measures such as fall rates.The other goals were not tracked.

Question 11

A nurse has administered the wrong medication to a patient.In investigating the root cause of the error, it is discovered that the nurse was unfamiliar with the medication and that the Pyxis was incorrectly loaded with the wrong medication.What should be the outcome of this process?
A)The nurse should be educated on this medication.
B)Pharmacy should develop a second check of medications prior to loading in the Pyxis.
C)The nurse will not be allowed to pass medications without supervision until deemed safe.
D)An incident report will be completed.

Accepted Answer

Pharmacy should establish a way to double check medications prior to loading, much like nurses triple check their medications before they are given.The other options would not accomplish the goal of prevention of future incidents.

Question 12

When using the DMAIC acronym of the Six Sigma quality process improvement model, the nurse understands that the I (improve) refers to
A)identification of the start and stop dates.
B)comparison of data to customer surveys.
C)use of technology to design improvements.
D)staff training.

Accepted Answer

Technology can allow for creativity in developing solutions.The others are processes that are incorporated in the other DMAIC approach to performance improvement.

Question 13

The Joint Commission ( TJC ) tracks core measures for performance.Which core measures are tracked by TJC? (Select all that apply.)
A)Heart failure
B)Ventilator days
C)Scheduled sedation vacation
D)Acute myocardial infarction
E)Childhood asthma

Accepted Answer

Options A, D, and E are core measures tracked by TJC.Options B and C are not one of the core measures tracked by TJC.

Question 14

When using the DMAIC acronym of the Six Sigma quality process improvement model, the nurse understands that the M (measure) refers to
A)the development of a data collection plan.
B)determination of the average LOS.
C)determination of the average wages.
D)determination of the ethnicity of admissions.

Accepted Answer

Data are necessary to determine process improvement.Options B, C, and D are incorrect because although they may individually be among the data collected, they do not by themselves define it.

Question 15

A sentinel event is usually one that results in an unexpected outcome for the patient and "signals" the need for investigation and response.Which of the following would be considered a sentinel event?
A)A patient with a brain tumor who falls and breaks his wrist after trying to get up by himself
B)A 32-year-old woman with no significant health history who dies in the operating room during an elective surgical procedure
C)A patient who self-extubates after cardiac surgery
D)A patient who is given the wrong bolus of heparin that is corrected with the first prothrombin time

Accepted Answer

The patient in option B died unexpectedly without apparent cause.Unexpected death or loss of limb or function did not occur.

Question 16

A sentinel event is usually one that results in an unexpected outcome for the patient and "signals" the need for investigation and response.Which of these situations would be considered a sentinel event?
A)Patient dies because there is no bed available in the ICU.
B)Patient receives an incorrect dose of medication.
C)Patient consents to be terminally weaned.
D)A patient's family is upset with a physician's approach.

Accepted Answer

The patient possibly died because appropriate care could not be delivered.The others are not a sentinel event.

Question 17

Patient satisfaction surveys include questions about quality of care.What has the greatest impact on patient satisfaction?
A)Responsiveness of staff
B)Getting pain medication on time
C)Being allowed to go outside to smoke a cigarette
D)The race and gender of the nurses

Accepted Answer

The attitudes and caring of the staff are a huge patient satisfaction indicator.The other options may be an indicator for a small number of patients but will not influence the overall data.

Question 18

What benchmarks might be expected to be measured for hospital performance? (Select all that apply.)
A)Average length of hospital stay for cardiac surgery
B)Total admissions for cardiac surgery
C)Infection rates for cardiac surgery
D)Length of surgery
E)Deaths by surgeon

Accepted Answer

Options A, B, and C are common benchmarks measuring hospital performance.Options D and E are not organizational measures but may be measured by the individual hospital or service.

Question 19

Hospital performance improvement standards are primarily focused on the ability of the hospital to
A)meet the goals established by the regulating bodies.
B)develop an atmosphere that meets and exceeds the expectations of the customers and staff.
C)be known in the community for good care.
D)provide a shelter for people in a disaster.

Accepted Answer

The focus of performance improvement is developed around excellence for the customers and staff.Although by meeting goals established by the regulating bodies, they may establish an environment of excellence, this is not the goal.Being known in the community for good care is public relations driven.Providing a shelter for people in a disaster is not a goal for performance improvement.

Question 20

Which of these is a measured outcome from a performance improvement process perspective?
A)Overtime hours worked by the RNs
B)Identifying the responsible person for a patient's fall
C)Sternal infection rates in cardiac surgery patients
D)Method of shift report

Accepted Answer

The number and frequency of sternal wound infections are patient outcomes.The others are not a performance improvement outcome.

Quiz 18: Improving Organizational Performance

A unit secretary mistakenly enters the wrong medication into the MAR when transcribing orders.After a root cause analysis, it is determined that the cause is the illegibility of the physician's order.Which measure should be taken to prevent future incidences?

What area is included when risk management explores the prevention of accidents, injuries, and errors?

When using the DMAIC acronym of the Six Sigma quality process improvement model, the nurse understands that the D (define) refers to

A nurse is learning about quality improvement measures taken by the hospital.Root cause analysis is a process for identifying the cause of an error.What is the greatest benefit to establishing the root cause?

"Lean culture" is a term used for the principle of eliminating waste.Which illustrates the principle that nurses must do more with less?

What is the best method for hospitals to track patient satisfaction?

A sentinel event is usually one that results in an unexpected outcome for the patient and "signals" the need for investigation and response.Which of the following would be considered a sentinel event?

The National Patient Safety Goals of The Joint Commission ( TJC ) are established goals to reduce the risks for injuries to patients and provide a safe environment.Which practice has been instituted as a result of these goals established by TJC?

Risk management is a hospital program organized to prevent the incidences of preventable accidents, injuries, and errors.Which of the following situations would a hospital risk manager need to investigate?

The National Database of Nursing Quality Indicators (NDNQI) has established which of the following goals to assist nurses to make practice changes in order to benefit patients?

A nurse has administered the wrong medication to a patient.In investigating the root cause of the error, it is discovered that the nurse was unfamiliar with the medication and that the Pyxis was incorrectly loaded with the wrong medication.What should be the outcome of this process?

When using the DMAIC acronym of the Six Sigma quality process improvement model, the nurse understands that the I (improve) refers to

The Joint Commission ( TJC ) tracks core measures for performance.Which core measures are tracked by TJC? (Select all that apply.)

When using the DMAIC acronym of the Six Sigma quality process improvement model, the nurse understands that the M (measure) refers to

A sentinel event is usually one that results in an unexpected outcome for the patient and "signals" the need for investigation and response.Which of the following would be considered a sentinel event?

A sentinel event is usually one that results in an unexpected outcome for the patient and "signals" the need for investigation and response.Which of these situations would be considered a sentinel event?

Patient satisfaction surveys include questions about quality of care.What has the greatest impact on patient satisfaction?

What benchmarks might be expected to be measured for hospital performance? (Select all that apply.)

Hospital performance improvement standards are primarily focused on the ability of the hospital to

Which of these is a measured outcome from a performance improvement process perspective?